| NPI | 1770140378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JO WARE Licensed Clinical Social Worker 909-600-4849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2022-09-07 |